Here's something nobody tells you early in your career: the thing that got you in the door is not the thing that keeps you moving forward.

I recently sat down with Pete Wickersham, a Vice President and General Manager running a UK pharma affiliate with over 200 employees and more than 25 years of industry experience. What struck me most wasn't the breadth of his career—from medical physics to biostatistics to clinical trials to general management—but the candour with which he described the uncomfortable transitions that made it possible.

This conversation is for anyone trying to figure out where they fit, how to lead, or how to keep growing when the ground beneath them keeps shifting.

Pete's career didn't follow a straight line. He started with a science degree, pivoted into what was meant to be a career in medical physics—designing radiation doses for oncology patients—and ended up taking statistics courses that opened the door to pharma. Someone came into a lecture and said: you could help us design and analyse clinical trials. That was the moment.

His advice for anyone early in their career isn't to find the perfect role. It's to find an entry point that suits your strengths at that moment in time. Once you're inside the industry, your curiosity and your performance can take you in directions you never anticipated.

The key insight here is that the entry point matters, but it's not the whole story. Pete is a strong advocate for the idea that most people won't have just one career—they'll have several. And if the first one doesn't land exactly as planned, that's not a failure. It's just the first chapter.

One of the more relatable moments in our conversation was when Pete described watching his university-age son agonize over a decision about his engineering studies. The son spent a month weighing options, going back and forth—and then hit a moment where he simply had to decide and move forward.

That, Pete argues, is just life. You gather the best information you can, you make the best decision you can, and then you commit. Even if the outcome isn't exactly what you hoped for, you can usually look back and say: given what I knew at the time, it was the right call.

This resonated deeply with me. I think many of us—especially in a world flooded with options and information—fall into analysis paralysis. The antidote isn't more data. It's the courage to choose.

Here's the part that nobody prepares you for. As your career progresses, you have to give up being the subject matter expert. Pete was blunt about this: early on, you are the person doing the work—building the HTA submission, running the analysis, preparing the campaign. Over time, you become less of a domain expert and more of a generalist. And that transition can be deeply uncomfortable.

Why? Because you have to become comfortable not being the smartest person in the room. Pete described entering meetings now where he knows people in that room will understand the technical details better than he does. And that's not a weakness—it's the point.

For anyone in HEOR, market access, or any technical discipline considering a move into leadership: this is the trade-off. You exchange depth for breadth. You stop providing the answers and start asking the questions.

When I pushed Pete on what actually makes a good leader, his answer surprised me in its simplicity: ask the right questions.

Not provide the right answers. Not have the best strategy. Ask the right questions.

His approach breaks down into three elements. First, prepare. Pete is a firm believer in the pre-read—coming into a conversation already informed about the context. Second, frame the problem. What are we trying to achieve? What's driving this situation? What are the constraints? Third, use questions to draw out the diverse perspectives in the room. Some people volunteer their views freely; others need to be pulled out.

The humility required for this approach is significant. Pete openly admitted there was a time in his career when he valued being the smartest person in the room. He doesn't anymore. And he described that shift as genuinely liberating—because when you stop trying to have all the answers, you start getting much better outcomes from your team.

I asked Pete how he manages his time given the sheer volume of competing priorities. His framework is straightforward: identify the two to four big priorities—the big rocks—and build your calendar around those. Everything else is the sand that fills in around them.

What's interesting is that those priorities don't always play out as expected. When Pete moved to the UK, he had a mental image of how he'd allocate his time across external government and environment issues versus internal operations. Reality didn't match. And that's the point—you need to keep reflecting and adjusting.

One non-negotiable for Pete: staying close to patients and the front lines. He described taking two train trips to Liverpool in a single week to meet healthcare professionals across different therapeutic areas. It keeps him informed, but more importantly, it keeps him grounded.

When it comes to leadership philosophy, Pete describes himself as a servant leader with accountability. His job, as he sees it, is to figure out what's in the way of the team achieving its goals and then help remove those obstacles. But it's not a one-way street. The team has to be all-in too.

The foundation of this approach? Two things: transparency and genuinely caring about people. Pete was emphatic that you can't fake caring. People know. They might not be able to articulate it, but if a leader says all the right things and doesn't back them up with action, the team feels it.

And action, in Pete's view, comes down to honouring your commitments. When someone asks for 10 minutes of your time, do you find it? When you say you'll do something, do you follow through? It sounds simple. But Pete described it as the very foundation of a leader's integrity—and the thing that bothers him most when he falls short of it.

We talked about how to build environments where people feel safe to experiment and grow. Pete shared an initiative from a recent town hall where the team introduced a "best learning" recognition. The initial instinct was to call it the "best failure" award, but they wisely reframed it. The goal isn't to celebrate failure for its own sake—it's to recognize the learning that propels someone forward.

He also described efforts to democratize AI adoption across the organization, encouraging grassroots experimentation and recognizing people who find creative applications. The idea is to build a culture where learning is visible, celebrated, and—critically—not confused with blame.

The recognition balance is tricky, though. Give everyone a trophy and it means nothing. The art is in making recognition feel earned and specific, not routine and hollow.

When I asked Pete for one piece of advice for the audience, he didn't talk about networking, credentials, or career strategy. He talked about mistakes.

Every career involves learning curves. Every new role, every new market, every new team. What separates people who grow from those who plateau isn't whether they make mistakes—everyone does. It's the speed at which they move through the learning curve afterward.

That speed comes from three things: recognizing when you've made a mistake (harder than it sounds), being open to feedback even when it's delivered imperfectly, and having the humility to process and learn rather than defend and deflect.

Pete put it memorably: the moment you think you've figured it out, you haven't. And if you ever truly stop learning, it's time to do something else.

This conversation reinforced something I've been thinking about a lot: the pharma industry rewards technical expertise early on, but the longer game is about adaptability, leadership, and the willingness to keep learning even when it's uncomfortable.

Three things I'm carrying forward from this conversation:

The entry point matters less than you think. Get in, be curious, perform well—and the path will unfold. Leadership is about asking, not answering. The best leaders I've encountered are the ones who create space for others to contribute, rather than trying to have all the answers themselves. Honour your commitments. It's the simplest leadership principle and the hardest to execute consistently.